| NPI | 1205348810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6133) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN276589) |
| Enumeration Date | 2017-11-05 |
| Last Update Date | 2017-11-05 |